Clomifene citrate (Clomid) is a tablet given to treat ovulatory problems which cause subfertility. For women who are not ovulating or who ovulate irregularly, approximately 80% will ovulate, increasing the chances of becoming pregnant.
There is a slightly higher incidence of a twin pregnancy in women taking clomifene (5-6%) but higher multiple pregnancies (triplets or quads) are very rare.
How does Clomifene work?
Clomifene is taken for five days at the start of the menstrual cycle. The tablets act by ‘fooling’ the brain into thinking that there are low levels of the hormone oestrogen in the body. The brain responds to this by putting out increased levels of the follicle-stimulating hormone (FSH) which encourages ovulation. Ovulation usually then occurs on day 12 to 14 of your cycle.
If you don’t have periods (or if they are very infrequent) you may also be prescribed a tablet called Medroxyprogesterone (Provera).
You are advised to do a home pregnancy test before taking Provera tablets
Provera 10mgs should be taken for seven consecutive days. You should then have a ‘withdrawal bleed’. It can take up to 10 days for this bleed to start after the last Provera tablet is taken. If you do not have this bleed more than 10 days after taking the last tablet, please contact the Fertility Nurse Specialist for advice.
If you start to bleed naturally while you are still taking the Provera tablets, simply stop taking these and start clomifene instead.
The first day of bleeding is called day 1 of your cycle. On the second day of bleeding (Day 2) you should start taking your clomifene tablets as explained below.
How do I take Clomifene?
The first day of bleeding is called Day 1 of your cycle. Clomifene at the prescribed dose (usually 50mg) should be taken starting on Day 2 and continuing to Day 6 of your cycle (i.e. for five days).
What are the side effects?
Most women have no side effects, but those that have been reported include hot flushes, breast or abdominal discomfort, mild nausea, and (rarely) blurred vision. Medication should be discontinued if your eyesight is affected. As previously discussed, there is also a higher risk of multiple pregnancy following clomifene treatment.
Ultrasound Scanning
On day 1 of you cycle that you are commencing clomid, please telephone the clinic to arrange an ovarian ultrasound scan (usually only done during the first cycle of treatment). This helps to determine when ovulation is taking place and to exclude overstimulation. It also helps us to advise you about the best time to have intercourse. Scanning is carried out between 8am and 9am only and the first scan is usually carried out on the 10th or 12th day of the cycle.
A blood test will be taken on of the first cycle treatment cycle to make sure you have ovulated. You may need to continue taking Clomifene for up to six months during which time the dose may be altered by the doctor or nurse depending on your response.
If over stimulation is seen on scan (too many follicles) then the treatment cycle will be cancelled and you will be asked to avoid intercourse until the start of your next cycle (to minimise the risk of multiple pregnancy).
Contact the Fertility Nurse Specialist, Forth Valley Royal Hospital Fertility Clinic Direct line: 01324 567166.